Wednesday, September 21, 2016

Two sides of total shoulders, one with osteolysis and one with decentering and a B2 glenoid

Here are the films of a painful left shoulder several in a 40+ year old patient who had had a series of labral repairs and a hemiarthroplasty prior to the short stemmed implant total shoulder performed elsewhere. The shoulder has been progressively more painful for the three years after the total shoulder. The x-rays show humeral and glenoid osteolysis. The patient has scheduled a single stage revision.

Three months ago the patient presented to us with an arthritic right shoulder. The axillary "truth" view shows a biconcave glenoid with posterior decentering.

The patient had a total shoulder arthroplasty using conservative glenoid reaming, a standard glenoid component and an anteriorly eccentric humeral head component with a thin stem inserted with impaction grafting.

At the three month checkup, the right shoulder is comfortable, mobile and gaining strength. The x-rays are shown below.

Note the amount of humeral and glenoid bone preserved with this approach.